ArticleEuropean heart journal. Cardiovascular Imaging2022
Real-world performance and accuracy of stress echocardiography: the EVAREST observational multi-centre study.
Article in European heart journal. Cardiovascular Imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06839755 (The Prognostic Value of Positive Stress Echocardiography and Its Relationship with Invasive Coronary Angiography), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Prognostic Value of Positive Stress Echocardiography and Its Relationship with Invasive Coronary Angiography: the AMPHIPOLIS Study
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Prognostic relevance of a false-positive stress echocardiography response: a systematic review and meta-analysis.Open heart · 2025Pooled it
- Long-term prognostic value of contemporary stress echocardiography in patients with suspected or known coronary artery disease: systematic review and meta-analysis.Heart (British Cardiac Society) · 2024Pooled it
- A proposal of an echocardiography-based pathway for the diagnosis and management of angina with no obstructive coronary arteries: a state-of-the-art review: Advancing Targeted Therapy and Prognosis Through Endotype Identification.European heart journal. Imaging methods and practice · 2026Review
- From Modified Haller Index to a Novel Patented Anatomical Measurement Device: Engineering Development, Validation, and Clinical Applications of Non-Invasive Thoracic Morphometry.Bioengineering (Basel, Switzerland) · 2026Review
- The Clinical Role and Impact of Dobutamine Stress Echocardiography in Liver Transplantation.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Unmasking Risk in Mitral Regurgitation: Prognostic Value of Exercise Stress Echocardiography-A Systematic Review.Journal of clinical medicine · 2026Review
- The Biological Cost of Every Heartbeat: Imaging-Derived Cardiovascular Vulnerability in Infective Endocarditis.International journal of molecular sciences · 2026Article
- Clinical determinants of agreement and discordance between stress SPECT and invasive coronary angiography.Frontiers in cardiovascular medicine · 2026Article
- Acute alterations in blood lactate in the setting of transient stress induced myocardial ischaemia.Experimental physiology · 2026Article
- Multimodality Cardiovascular Imaging in Patients After Coronary Artery Bypass Grafting: Diagnosis and Risk Stratification.Diagnostics (Basel, Switzerland) · 2025Review
- Contemporary review of stress echocardiography workforce within the UK: an EVAREST/BSE NSTEP study.Echo research and practice · 2025Article
- Global Longitudinal Strain in Stress Echocardiography: A Review of Its Diagnostic and Prognostic Role in Noninvasive Cardiac Assessment.Diagnostics (Basel, Switzerland) · 2025Review
- Clinical research and trials in echocardiography: rationale, requirements and future opportunities.Echo research and practice · 2025Review
- What role for cardiac imaging in chronic coronary syndromes: review of the literature in light of the latest recommendations.European heart journal. Imaging methods and practice · 2025Review
- Changes in coronary disease management decisions in real-world practice between 2015 and 2023: insights from the EVAREST/BSE-NSTEP observational study.European heart journal. Cardiovascular Imaging · 2025Observational
- Visual Assessment and Longitudinal Strain During Dobutamine Stress Echocardiography.Diagnostics (Basel, Switzerland) · 2025Article
- Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study.European heart journal. Cardiovascular Imaging · 2025Article
- Article
- Assessing Cardiovascular Risk with Coronary Artery Calcium and Carotid Intima-Media Thickness in Patients with Negative Stress Echocardiography.Biomedicines · 2024Article
- Stress Echocardiography for Chronic Coronary Syndrome: Clinical Practice Guidelines (2023).Journal of geriatric cardiology : JGC · 2024Article
Corrections and comments
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Authors and funding
46 authors at 20 institutions in 1 country.
Funding
Abstract
aimsStress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography. METHODS AND
resultsParticipants undergoing stress echocardiography for CAD were recruited from 31 hospitals. Participants were followed up through health records which underwent expert adjudication. Cardiac outcome was defined as anatomically or functionally significant stenosis on angiography, revascularization, medical management of ischaemia, acute coronary syndrome, or cardiac-related death within 6 months. A total of 5131 patients (55% male) participated with a median age of 65 years (interquartile range 57-74). 72.9% of studies used dobutamine and 68.5% were contrast studies. Inducible ischaemia was present in 19.3% of scans. Sensitivity and specificity for prediction of a cardiac outcome were 95.4% and 96.0%, respectively, with an accuracy of 95.9%. Sub-group analysis revealed high levels of predictive accuracy across a wide range of patient and protocol sub-groups, with the presence of a resting regional wall motion abnormalitiy significantly reducing the performance of both dobutamine (P < 0.01) and exercise (P < 0.05) stress echocardiography. Overall accuracy remained consistently high across all participating hospitals.
conclusionStress echocardiography has high accuracy across UK-based hospitals and thus indicates stress echocardiography is being delivered effectively in real-world practice, reinforcing its role as a first-line investigation in the assessment of patients with stable chest pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.